Diabetes最新文献

{"title":"1664-P: Prostaglandin E2 Stimulates GLP-1 Secretion in the Isolated Perfused Rat Small Intestine","authors":"JONATAN K. FRIIS, TYLER A. COOKSON, IDA M. MODVIG, VALENTINA ABBA, JENS J. HOLST, SIMON VEEDFALD","doi":"10.2337/db25-1664-p","DOIUrl":"https://doi.org/10.2337/db25-1664-p","url":null,"abstract":"Introduction and Objective: Prostaglandins (PG) stimulate intestinal mucous secretion and blood flow, but their role in gut hormone secretion remains ambiguous. Conflicting studies suggest both positive and negative effects of PG on hormone and glucose metabolism. We aimed to investigate the effects of PGE2, PGD2, PGF2α, and PGI2 on small intestinal glucagon-like peptide-1 (GLP-1) secretion. Methods: Isolated rat small intestine was vascularly perfused using a single-pass system with a modified Krebs-Ringer bicarbonate buffer. Arterial (7.5 mL/min) and luminal (0.250 mL/min) flow were clamped. In separate experiments, PGE2 (10-9 M to 10-5 M), PGD2, PGF2α, and PGI2 (0.1 μM, 1 μM) were infused intravascularly for 10-minutes with 20-minute washouts. GLP-1 was measured by radioimmunoassay; percent change from baseline was assessed by one-way ANOVA. Results: Infusion of 1 μM PGE2 significantly increased GLP-1 secretion (+206%, p=0.002; Fig C, D), but not at 1 nM (p=0.79), 10 nM (p=0.76), 100 nM (p=0.72) (Fig A, B) or 10 μM (p=0.20; Fig C, D) (n=4). Neither PGD2 (0.1 μM: p=0.56; 1 μM: p>0.99), PGF2α (0.1 μM: p=0.78; 1 μM: p>0.99), nor PGI2 (0.1 μM: p=0.92; 1 μM: p=0.40) stimulated GLP-1 secretion. Conclusion: PGE2 uniquely stimulates GLP-1 secretion in the perfused rat small intestine, exhibiting a bell-shaped dose response curve. This links inflammatory mediators to gut-protective hormone release. Disclosure J.K. Friis: None. T.A. Cookson: None. I.M. Modvig: None. V. Abba: None. J.J. Holst: Advisory Panel; Novo Nordisk A/S. Consultant; Novo Nordisk A/S. Other Relationship; Novo Nordisk A/S. Consultant; AstraZeneca, Fractyl Health, Inc., MSD Life Science Foundation, Structure Therapeutics, Inc. S. Veedfald: None. Funding Dansk Frie Forskningsråd (3101-00127A)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"20 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"1998-LB: A Two-Year Trial of Metformin to Reduce Frailty in Older Adults with Glucose Intolerance","authors":"SARA E. ESPINOZA, CHEN-PIN WANG, NICOLAS MUSI","doi":"10.2337/db25-1998-lb","DOIUrl":"https://doi.org/10.2337/db25-1998-lb","url":null,"abstract":"Introduction and Objective: Frailty is a major cause of morbidity and disability in older adults and insulin resistance is an important risk factor for frailty. We conducted a randomized, double blinded, placebo-controlled clinical trial of metformin in older adults (≥65 years) with glucose intolerance to determine its effect on frailty. Methods: Participants were randomized to 24 months of metformin (initiated at 500 mg/day and titrated to maximum tolerated dose up to 2,000 mg/day) or matching placebo. All participants received one session of diet and exercise counseling prior to initiation of study drug. The primary outcome was frailty as measured by the frailty index based on deficit accumulation model and frailty phenotype based on Fried criteria, which was assessed every 6 months. Using intention to treat, we conducted generalized estimating equations (GEE) models to examine the change in frailty per month by frailty index and Fried criteria. Results: One hundred forty-five participants were randomized; intention to treat analysis included 141 participants who took at least one dose of study drug. At baseline, participants were 48% female, 35% Hispanic/Latino, and mean age was 71.8 ±5.3 years. Metformin did not cause serious adverse events. Metformin led to a significant reduction in frailty progression rate per month assessed by frailty index compared to placebo (-0.0494 ±0.0216, 95%CI: -0.0918, -0.0071, p=0.0222). No difference was observed by Fried criteria (0.0116 ±0.0077, 95%CI: -0.0034, 0.0266, p=0.1302). Conclusion: Metformin administration to older adults with glucose intolerance may be useful for the prevention of frailty and extension of healthspan. Disclosure S.E. Espinoza: None. C. Wang: None. N. Musi: None. Funding National Institutes of Health (R01AG052697)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"602 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"935-P: Personality Traits and Glycemic Control in Type 1 Diabetic Patients with Different Insulin Therapies","authors":"EUGENIA RESMINI, ANGELO V. CORNAGHI, VALENTINA TURRA, EMANUELA ZARRA, ELENA CIMINO, MARCO SANDRI, MATTEO MIGAZZI, GIULIA MASSARI, BERNADETTA PASQUINO, CRISTINA MASCADRI, SARA MADASCHI, ANGELA GIRELLI","doi":"10.2337/db25-935-p","DOIUrl":"https://doi.org/10.2337/db25-935-p","url":null,"abstract":"Introduction and Objective: Glycemic variability is becoming increasingly important in evaluating effectiveness of treatment in patients with type 1 diabetes. Personality traits may impact daily therapeutic decisions, potentially affecting quality of glycemic control. This study aimed to explore potential relationship between personality traits and glycemic control, and to examine differences across various insulin therapies. Methods: Cross-sectional observational study, 130 type 1 diabetic patients (68 females, 62 males, 43.77±12.81 years, BMI 24.95±4.57 kg/m2, disease duration 23.23±12.39 years, HbA1c 7.04±0.92%), divided in three groups: 1. Multiple daily injections (MDI, n=45); 2. Traditional pumps (TP, n=35); 3. Advanced hybrid closed-loop systems (AHCL, n=50). Personality was assessed through the Personality Inventory for DSM-V questionnaire. Kruskal-Wallis test for independent samples was used to compare continuous variables among three groups. Associations between pairs of variables were analyzed using Spearman’s correlation. Results: AHCL group showed higher emotional lability (p=0.042), perseveration (p=0.005), separation insecurity (p=0.007) and distractibility (p=0.021) than MDI and TP group. The pathological trait of emotional lability (above the 75th percentile) was more frequently present in the AHCL (32%, p=0.029) than MDI and TP group. This trait was associated with an increase in TAR>180 (p=0.035) and GMI (p=0.025), a decrease in TBR<70 (p=0.014). However, glycemic control and metrics were significantly better in the AHCL than MDI and TP group (HbA1c, p=0.03; GRI, p<0.001; TIR, p=0.004; TAR>180, p=0.05; TBR<70, p=0.018, TAR>250, p=0.041; CV, p=0.012; SD, p=0.01). Conclusion: AHCL systems may help mitigating the impact of problematic personality traits, that could interfere achieving an optimal glycemic control. Disclosure E. Resmini: None. A.V. Cornaghi: None. V. Turra: None. E. Zarra: None. E. Cimino: Speaker's Bureau; roche, Abbott. M. Sandri: None. M. Migazzi: None. G. Massari: None. B. Pasquino: None. C. Mascadri: None. S. Madaschi: None. A. Girelli: Consultant; Abbott Diagnostics, Sanofi, Roche Diabetes Care.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"10 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"1786-P: Trends in Diagnosed Diabetes Prevalence across Anthropometric Measurements in the United States, 2001–2023","authors":"DAESUNG CHOI, STEPHEN J. ONUFRAK, IBRAHIM ZAGANJOR, JEAN M. LAWRENCE, SOLA HAN, KAI M. BULLARD, LYUDMYLA KOMPANIYETS, MEDA E. PAVKOV","doi":"10.2337/db25-1786-p","DOIUrl":"https://doi.org/10.2337/db25-1786-p","url":null,"abstract":"Introduction and Objective: To assess trends in prevalence of diagnosed diabetes during 2001-2023 across categories of three anthropometric measures: BMI, waist circumference (WC), and waist-to-height ratio (WHtR). Methods: Data were from the National Health and Nutrition Examination Survey from 2001-2023 for 53,450 participants aged ≥ 20 years. Diagnosed diabetes (DM) was defined based on self-reported physician diagnosis. Age-standardized prevalence of DM and annual percentage change (APC) were estimated by anthropometric categories. Results: Between 2001-2004 and 2021-2023, the age-standardized prevalence of DM increased from 5.7% to 7.9% among those with BMI 25 - 29.9 kg/m² (APC: 2.2%, P < 0.05) and from 12.1% to 14.8% in those with BMI ≥30 kg/m² (APC: 1.1%, P < 0.05), with no significant changes for BMI <25 kg/m². DM prevalence increased from 9.3% to 13.0% in the high WC (≥102cm for men and ≥88cm for women) group (APC: 1.6%, P < 0.05) and from 11.7% to 15.2% in the high WHtR (≥0.6) group (APC: 1.3%, P < 0.05). Changes in DM over time for moderate WC and WHtR were not significant. Conclusion: Prevalence estimates for DM were higher after 2017-2020 than in 2001-2004 for all anthropometric categories. The growing prevalence of DM in individuals with higher BMI, WC, and WHtR highlights the significant role of adiposity in diabetes risk in the U.S. Disclosure D. Choi: None. S.J. Onufrak: None. I. Zaganjor: None. J.M. Lawrence: None. S. Han: None. K.M. Bullard: None. L. Kompaniyets: None. M.E. Pavkov: None.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"602 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"205-OR: Adhesion-Related Macrophages Regulates Metabolic Homeostasis through Cav-1 Dependency","authors":"WANYU HU, TUO DENG","doi":"10.2337/db25-205-or","DOIUrl":"https://doi.org/10.2337/db25-205-or","url":null,"abstract":"Introduction and Objective: The significance of adipose tissue macrophages (ATMs) in regulating adipose tissue function is well-established. However, our investigation revealed a previously overlooked subpopulation of macrophages adhered to adipocytes, which we term adhesion-related macrophages (ARMs). Methods: We developed a method to isolate both ARMs and non-ARMs. Molecular and functional differences were analyzed, and Cav-1 knockout mice were utilized to study the role of ARMs in metabolism. Results: Our findings demonstrate that ARMs constitute the predominant expanded subpopulation of ATMs during obesity, exhibiting heightened adhesion, proliferation, and lipid-processing capacities. Notably, ARMs can be characterized by a key functional marker, Caveolin-1. Genetic ablation of Caveolin-1 in immune cells significantly diminishes ARM abundance, disrupting their adhesion capacity and lipid content, leading to adipocyte hypertrophy, adipose tissue expansion, and impaired glucose homeostasis. Reintroducing ARMs from lean mice into eWAT mitigate obesity-induced adipose tissue inflammation and insulin resistance. Conclusion: Our study uncovers a previously unexplored macrophage subpopulation, ARMs, revealing potential therapeutic targets for obesity-induced insulin resistance and opening avenues for identifying similar paradigms in other tissues and diseases. Disclosure W. Hu: None. T. Deng: None. Funding National Key R&D Program of China (2020YFA0803604 and 2023YFC3603404), the Key Program of the National Natural Science Foundation of China (82130024), the Fund for International Cooperation and Exchange of the National Natural Science Foundation of China (8231101033).","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"12 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2060-LB: Benchmarking AI in Type 1 Diabetes Management—How Well Do Generative AI Platforms Follow ADA SOC?","authors":"GEANNA JADA MIRANDA, SHIRLEY M.T. WONG, CLIPPER F. YOUNG","doi":"10.2337/db25-2060-lb","DOIUrl":"https://doi.org/10.2337/db25-2060-lb","url":null,"abstract":"Introduction and Objective: With the rise of generative AI in healthcare, this study evaluates the internal consistency (within platforms) and external consensus (among the platforms) of diabetes care following the ADA SOC generated by AI platforms (OpenAI ChatGPT-4, Google Gemini, Copilot, Perplexity) and compare their responses with clinicians’ notes. Methods: Eight de-identified clinical cases with type 1 diabetes were extracted from a database and edited for clarity. Cases were input into the platforms, generating seven rounds of responses per case per platform. Outputs were analyzed across seven themes: Glycemic management; Lifestyle recommendations; Patient education; Psychosocial considerations; Preventative screenings and immunizations; Patient-specific considerations; and Social determinants of health. Results: Conclusion: The AI platforms showed various levels of internal consistency in their responses, with the highest consistency in CGM patient education. For external consensus among all platforms, the theme with the closest scores was CGM patient education; however, the theme with the highest Jaccard Similarity Score was Discussing Insulin Treatments. AI-generated guidance diverged markedly from clinicians’ recommendations. While more research is needed, these findings emphasize the potential of AI in supplementing diabetes care and highlight the need for human oversight to ensure comprehensive, patient-centered management. Disclosure G. Miranda: None. S.M. Wong: None. C.F. Young: Consultant; Sanofi.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"4 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"322-OR: Higher Placental GKN1 Expression Is Associated with Reduced Pregnancy Beta-Cell Function","authors":"CAMILLE E. POWE, FRÉDÉRIQUE WHITE, CATHERINE ALLARD, LYDIA SHOOK, FRANCOIS AGUET, KRISTIN ARDLIE, ANDREA EDLOW, LUIGI BOUCHARD, PIERRE-ETIENNE JACQUES, JOSE C. FLOREZ, S. ANANTH KARUMANCHI, MARIE-FRANCE HIVERT","doi":"10.2337/db25-322-or","DOIUrl":"https://doi.org/10.2337/db25-322-or","url":null,"abstract":"Introduction and Objective: We aimed to identify candidate placental proteins that impact beta-cell function in human pregnancy through transcriptome-wide placental gene expression analysis. Methods: In the Gen3G cohort, we measured glucose and insulin levels fasting, 1, and 2 hours after a 75-gram oral glucose load given at 24-30 weeks’ gestation. We calculated the Pregnancy Insulin Physiology (PIP) Index, a measure of pregnancy beta-cell function. We performed bulk RNA sequencing of placental samples (N=15,216 RNA transcripts) and analyzed differential gene expression to identify transcripts most strongly associated with beta-cell function (PIP index, box-cox transformed, standardized) after adjustment for maternal age, gravidity, body mass index (BMI), gestational age at delivery, and offspring sex. We used the false discovery rate (FDR) to adjust P-values. We then quantified nominal associations (P<0.05) between identified transcripts and other glycemia-related traits with weighted linear regression models. Results: In 433 cohort participants, we identified GKN1, encoding gastrokinin 1, as the top differentially expressed gene in relation to the PIP index. Gastrokinin 1, a secreted protein highly expressed in the stomach, has putative roles in mucosal homeostasis and fat metabolism. Higher placental GKN1 expression was associated with lower beta-cell function (log2 change in GKN1 expression per SD change in beta-cell function=-0.44, FDR=8.1×10-6). Placentas from pregnancies with gestational diabetes had higher GKN1 expression compared to unaffected pregnancies (log2 fold change=1.13, FDR= 4.2×10-3). Higher GKN1 expression was associated with higher BMI (β=0.2, P=0.04), post-load glucose (β=0.3, P=3.5×10-5) and insulin (β=0.2, P=0.007), and lower insulin sensitivity-adjusted Stumvoll first phase estimate (β=-0.2, P=0.001). Conclusion: Higher placental GKN1 expression is associated with reduced beta-cell function in pregnancy and gestational diabetes. Disclosure C.E. Powe: Research Support; Dexcom, Inc. Other Relationship; Mediflix, Wolters Kluwer Health. F. White: None. C. Allard: None. L. Shook: None. F. Aguet: Employee; Predicta Biosciences, Illumina, Inc. K. Ardlie: None. A. Edlow: Research Support; Merck Sharp & Dohme Corp. Consultant; Merck Sharp & Dohme Corp, Mirvie, Inc. L. Bouchard: None. P. Jacques: None. J.C. Florez: Research Support; Novo Nordisk. S. Karumanchi: Consultant; Thermofisher Scientific, Comanche Biopharma. Stock/Shareholder; Aggamin Therapeutics, Roche Diagnostics. Other Relationship; Beth Israel Deaconess Medical Center, Cedars-Sinai Medical Center. M. Hivert: None. Funding National Institutes of Health (R01HD094150)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"26 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2078-LB: Prenatal Exposure to Maternal Obesity or Gestational Diabetes Is Associated with Gut Hormone Dysregulation in Children","authors":"ELLA C. MORGAN, JASMIN M. ALVES, TING CHOW, ANNY XIANG, KATHLEEN A. PAGE","doi":"10.2337/db25-2078-lb","DOIUrl":"https://doi.org/10.2337/db25-2078-lb","url":null,"abstract":"Introduction and Objective: Children of mothers with obesity or gestational diabetes mellitus (GDM) face increased metabolic risk, yet mechanisms remain unclear. The gut hormones, GLP-1 and ghrelin, regulate appetite and glucose metabolism. GLP-1 enhances insulin secretion and satiety, while ghrelin stimulates hunger. We investigated whether exposure to maternal obesity or GDM is associated with alterations in GLP-1 and ghrelin responses to oral glucose. Methods: The analysis included 19 children (68% female; 12 GDM-exposed, 7 unexposed) aged 7-14 years from the BrainChild Study. Maternal pre-pregnancy BMI and GDM status were extracted from electronic medical records. Stored plasma samples were assayed for gut hormones collected after a 12-hour fast and 30-min post-oral glucose load (1.75 g/kg body weight). A multiplex immunoassay (MilliporeSigma) quantified active ghrelin and GLP-1. Spearman correlations assessed associations between maternal pre-pregnancy BMI and child hormone levels, and independent t-tests compared hormone responses between GDM-exposed and unexposed children, before and after adjusting for child age and sex. Results: Compared to unexposed children, GDM-exposed children had smaller post-glucose increases in GLP-1 levels (unadjusted: 29.07 vs. 17.87 pg/ml, p=0.17; adjusted: 29.13 vs. 17.95 pg/ml p=0.20) and less ghrelin suppression (unadjusted: -99.68 vs. -34.49 pg/ml, p=0.05; adjusted: -101.31 vs -43.19 pg/ml, p=0.08), respectively. Maternal pre-pregnancy BMI correlated with lower child GLP-1 secretion (unadjusted: ρ =-0.30, p=0.21; adjusted: ρ =-0.25, p=0.33) and less ghrelin suppression (unadjusted: ρ =0.55, p=0.01; adjusted: ρ =0.52, p=0.03). Conclusion: These preliminary findings suggest that prenatal exposure to maternal GDM or obesity is associated with altered GLP-1 and ghrelin responses to oral glucose. Further research is needed to elucidate how these changes contribute to metabolic risk in children. Disclosure E.C. Morgan: None. J.M. Alves: None. T. Chow: None. A. Xiang: None. K.A. Page: None. Funding American Diabetes Association (1-14-ACE-36); NIH (RO1DK134079), (RO1DK116858)","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"225 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"992-P: A Retrospective Comparative Study of Glycemic Control Metrics at Six Months in 133 Patients with Type 1 Diabetes after Switching from isCGM to rtCGM with the Same Sensor Profile","authors":"DAN SEKIGUCHI, YASUTAKA MAEDA, MAYUKO MORITA, YUKIE KUROGI, MASAE MINAMI","doi":"10.2337/db25-992-p","DOIUrl":"https://doi.org/10.2337/db25-992-p","url":null,"abstract":"Introduction and Objective: In Japan, FreeStyle Libre 2 (Libre 2)​ was approved as real-time continuous glucose monitoring (rtCGM) only when used smartphone application since its initial release, December 2023. Because early approval as rtCGM like Japan is uncommon, the efficacy of switching from intermittently scanned CGM (isCGM) to rtCGM with identical accuracy and specifications remains unclear. Methods: This retrospective study included adults with type 1 diabetes. Changes in HbA1c and CGM metrics were assessed ​before and 6 months after ​switching from isCGM to rtCGM. ​In patients switched from isCGM to isCGM with ​low and high glucose alert function​s (​Libre 2 reader users), due to ​difference of ​release day between the ​reader and app, only 3-month data were analyzed. Results: Of 133 patients enrolled from January 2024 through June 2024. 67 (50.4%) were male​; the mean (±SD) age of the patients was 45.6 ± 15.3 years and HbA1c ​was 7.51 ± 0.64%. At 6 months post-​switching, significant improvements were observed in mean HbA1c (7.51 vs. 7.35, p < 0.01), TAR (37.5% vs. 35.3%, p < 0.01), TIR (58.7% vs. 61.4%, p < 0.01), TITR (37.6% vs. 39.0%, p = 0.04), CV​ (38.0​% vs. 36.3​%, p < 0.01) and MAGE (127.3​mg/dL vs. 118.9​mg/dL, p < 0.01). No significant differences were ​o​bserved for TBR (3.72% vs. 3.33%, p = 0.13) or Level 2 TBR (0.51% vs. 0.38%, p = 0.16). Similar effects on HbA1c and CGM metrics were observed in a 3-month analysis.​ On the other hand, 35 patients ​switched from isCGM to isCGM with alert function​s showed no significant differences in HbA1c, TIR, TAR, and TBR at 3 months. Conclusion: Switching from isCGM to rtCGM improved glycemic control at 6 months in patients with type 1 diabetes. The lack of improvement in HbA1c and CG​M metrics in patients using isCGM with alert function​s suggests monitor​ing ​real-time glucose levels​, rather than alert​ functions, may play a crucial role in achieving better ​glucose outcomes. Disclosure D. Sekiguchi: None. Y. Maeda: None. M. Morita: None. Y. Kurogi: None. M. Minami: None.","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"42 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"161-OR: Prediabetes Remission and Cardiovascular Mortality and Morbidity","authors":"ELSA VAZQUEZ ARREOLA, ROBERT L. HANSON, ARVID SANDFORTH, LEONTINE SANDFORTH, SARAH KATZENSTEIN, NORBERT STEFAN, HUBERT PREISSL, NIKOLAUS MARX, REINER JUMPERTZ VON SCHWARTZENBERG, ANDREAS L. BIRKENFELD","doi":"10.2337/db25-161-or","DOIUrl":"https://doi.org/10.2337/db25-161-or","url":null,"abstract":"Introduction and Objective: Lifestyle interventions (LI) are effective in preventing T2D in people with prediabetes. Whether this approach also reduces cardiovascular (CV) death and heart failure (CHF) in people with prediabetes is matter of debate. We tested the hypothesis whether remission of prediabetes to normal glucose regulation (NGR; FPG<5.6 mmol/l, 2-h glucose OGTT <7.8 mmol/l, HbA1c <39 mmol/mol) reduces CV complications in people with prediabetes. Methods: In the Diabetes Prevention Program Outcomes Study (DPPOS) Phase 3 from the NIDDK repository from all three treatment arms (LI, metformin, placebo) with data for up to 21 years of follow-up were analyzed. Participants were separated into responders (i.e. remission to NGR) and non-responders (non-remission to NGR) based on the response at year 1 of the DPP intervention. Outcomes included 1) a composite of CV death and hospitalization for CHF and 2) extended MACE (CV events/death, arterial revascularization, hosp. for CHF or unstable angina, diagnosis of coronary heart disease or silent myocardial infarction). Results: Of 2427 participants, 278 (11%) were responders and 2149 (89%) non-responders at year 1. At baseline, BMI was 32.3kg/m2 (IQR: 28.7, 37.0) in responders and 32.5Kg/m2 (28.8, 37.1) in non-responders, and was reduced to 30.1kg/m2 (26.6, 34.2) and 31.4kg/m2 (27.7, 36.2; both p<0.01), respectively. In total, 93 of 278 (33.5 %) responders were diagnosed with T2D during DPPOS phase 3 compared to 1215 of 2149 (56.5 %) non-responders (p<0.001). During a mean observation time of 21 years and after adjustment for available risk factors, including baseline body weight, age, development of T2D, randomization assignment and medication, responders had lower relative risk (RR) for the composite endpoint of CV death and CHF (RR=0.43 (95 % CI: 0.21, 0.90); p=0.02) and for extended MACE (RR=0.60 (0.41, 0.89) p=0.01) than non-responders. Conclusion: LI-induced prediabetes remission markedly reduced CV morbidity and mortality in people with prediabetes. Disclosure E. Vazquez Arreola: None. R.L. Hanson: None. A. Sandforth: None. L. Sandforth: None. S. Katzenstein: None. N. Stefan: Speaker's Bureau; AstraZeneca, Boehringer-Ingelheim. Consultant; Lilly Diabetes. Speaker's Bureau; Lilly Diabetes. Consultant; Pfizer Inc. Speaker's Bureau; Sanofi. Research Support; Sanofi. Speaker's Bureau; Novo Nordisk, GlaxoSmithKline plc. Consultant; GlaxoSmithKline plc. H. Preissl: None. N. Marx: Speaker's Bureau; Abbott, Amgen Inc, AstraZeneca. Advisory Panel; AstraZeneca. Speaker's Bureau; Bayer Pharmaceuticals, Inc. Advisory Panel; Bayer Pharmaceuticals, Inc. Speaker's Bureau; Boehringer-Ingelheim. Advisory Panel; Boehringer-Ingelheim. Speaker's Bureau; Daiichi Sankyo. Advisory Panel; Merck Sharp & Dohme Corp. Speaker's Bureau; Novo Nordisk. Advisory Panel; Novo Nordisk. Speaker's Bureau; Sanofi. Advisory Panel; Sanofi. Speaker's Bureau; Lilly Diabetes. R. Jumpertz von S","PeriodicalId":11376,"journal":{"name":"Diabetes","volume":"591 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}